ComplaintsforSSM Health St. Louis

• Initial Complaint

  07/17/2024

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  I filled out a financial aid application back in the beginning of February this year (2024).Along with the applocation, i had printed out my current taxes, the bank stubs, and other items they had asked for and sent it in a large packet (that i had paid extra to send) to SSM financial aid ****).In the months of march and april, i would recieve notices saying that my schedule C and another page was missing from my taxes along with another section, to every time, I replied that it wasnt. I am self employed and that i didnt purposely leave out sections of my taxes when i made copies- everything I had was submitted. **************** would note my account (because they wont let you talk to financial aid directly), and the same thing would happen and repeat every 1-2 weeks. I emailed once on May 6 to financial (after the 6-8 failed attempts of contacting customer service to relay the message asking what was going on. Finally i got ahold of one financial aid lady and all she said was 'they didnt have it'. Which, i dont know where the rest of my personal info is now if they only have half??I just resent the sections to financial aid to get the process moving because it had already been almost 4 months.Since then it has been crickets. My account is still outstanding. I called in the beginning of June and customer service said it was pending and to give it 30 days (even though it had already been almost 60). I emailed the financial aid **** on July 13 asking again what the satus of my application was and have had no reply yet.Attempts to contact financial aid/customer service are also in my MyChart messages but I cannot screenshot them due to 'security reasons'. This entire application process has now been dragged out close to 6 months and my my personal tax information seemed to just 'dissappear'..

  Business response

  07/18/2024

  This correspondence serves as SSM Health's response to Complaint # ********. 

  SSM Health ******************************* contacted the consumer on 7/18/24 and provided an update and explanation of the process that was followed. The consumer now understands and is accepting of the outcome. 

  Thank you for allowing us the opportunity to respond to this complaint. 

  ***** SSM Health Patient Financial Services 

  Customer response

  07/19/2024

  1Complaint: 22001548
  
  I am rejecting this response because:
  
  SSM reached out to my personal phone. The lady explained that my initial inquiry for financial assistance fell out of their work que and it was 'being investigated' by Epic.  Somehow part of my taxes that i initially sent and sent a 2nd time were both missing pieces even though I had sent them exactly what they had asked for both times.  Because of the failure of communication/no notice back in April when i was told to send more information the 2nd time, my original application 'timed out' so in order to recieve help again, I would have to reapply and resend all of my information a 3rd time, and I am not willing to continue to do this goofy process again and waste my time.  Financial aid assistant informed me that i qualified for help (based off of my income, even though somehow they didnt recieve all of my info?) but informed me that financial aid is only available to bills greater than $2000.  So! it does not make sense for me to apply as I dont have any other bills in this period anyways. 

  Poor communication on this whole event, no numbers to contact financial aid directly, no replies to any emails. and very   disappointed that help is only offered to those who have bills greater than $2000, as I cannot find it stated anywhere (or i wouldnt have applied and gone through this circus of hoops in the first place and wasted 6 months of my time).
  
  Sincerely,
  
  ***************************

• Initial Complaint

  06/30/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  My family gets ****************** and it covers 100% of medical, especially emergency even if youre traveling. This hospital system coded my small daughters ER visit incorrectly way back in December, and has been billing me because of the error. I only found out by doing the work for these paid employees instead. It was from my own HMO that I found out what mistake was after many messages and letters about this bill and my phone calls to ***. All but the lead customer service agency blamed me for being responsible, told me my HMO didnt do their job because they didnt send them an explanation of benefits, and they didnt even know what the term HMO means, that I have coinsurance and a copay and that I was responsible. I was badgered and bullied and lied to.What really happened is that the *** coded it as a regular office visit when the visit was actually for my 5 year old daughters positive strep test.Now, even after I had a 2 way message about the coding error with ***,NOW I am getting letters and phone calls from a collection agency.How much you want to bet its their angry and abusive employees that actually have copays and co-insurance and that theyre bullying me in a discriminatory way because they think they can.Dont go to this ER, if you had to be hospitalized they would probably s**** up your coding and insurance.Not only that, its the location they bring all the maximum security prisoners to in dire need only.

  Business response

  07/01/2024

  This correspondence serves as SSM Health's response to Complaint # ********. 

  Due to an error within the cash posting department, the guarantor received a billing statement. The account has been corrected and the balance recalled from outside collections with no adverse effect to the guarantor's credit. The balance is now $0.00 and this consumer will no longer receive billing statements for this date of service. We apologize for the inconvenience this has caused. 

  Thank you for allowing us the opportunity to respond to this complaint. 

  ************** SSM Health ***************** Services

• Initial Complaint

  06/25/2024

  Complaint Type:

  Product Issues

  Status:

  Resolved

  More info

  Date of service 2/1/23 & 7/20/23 $34 for each service for a total of $68 BCBS in-network doctor ordered labs Dispute is Assay of Lipoprotein lab work ordered by in-network doctor is not covered by BCBS and neither doctor or lab communicated this before either date of service. I tried to resolve the issue with the doctors office who initially stated the issue was with the *** coding used for this lab work. I assumed it was a coding error when I had the second service on 7/20/23. It wasnt until I received a bill 9/19/23 for the service performed 2/1/23 when I realized the coding had not been changed. The doctors office then recommended I work with my insurance BCBS on coverage. I submitted two appeals, which were denied. While waiting on appeal results, I worked with SSM Billing via MyChart messages and phone calls requesting to waive the cost of these labs because I used an in-network provided and it was never communicated with me that the labs were not covered. Feb 24-May 24 SSM has communicated multiple times my issue has been escalated for review with the last time on 5/10/24 via phone. I received a letter from a debt collector on this issue dated 5/13/24. I sent the debt collector a letter explaining I was working with SSM on this issue. I received a letter dated 6/17/24 from the debt collector stating they confirmed the amount owed from SSM Health. As of 6/25/24, I have yet to receive a response from SSM Health. I noticed SSM has responded to complaints on the BBB site and decided this method may get a response. I received several messages in MyChart on Your Rights and Protections Against Surprise Medical Bills. These rights only appear to be when using out of network doctors and facilities. Apparently, you dont have rights when using in-network doctors and facilities. They can order services not covered by your insurance and you are responsible for all cost. I may have been lucky this time at $68, but if it had been hundreds or thousands of dollars?

  Business response

  06/28/2024

  This correspondence serves as SSM Health's response to Complaint # ********. 

  The complaint states neither SSM Health nor Labcorp advised an ordered service was not a covered benefit under the consumers insurance plan. 

  This test was denied by insurance as not a covered benefit. Neither the ordering provider nor the lab obtained authorization because none was needed. Neither the provider nor the lab would be aware of the benefits and or limitations of the consumers insurance plan. SSM bills insurance as a courtesy to the patient but cannot be held responsible for coverage. SSM Health ************* would not know to what extent the service is covered until the claim is processed. Each insurance company sets its own coverage guidelines based on a variety of considerations.

  The denied charges were adjusted as a one-time courtesy for good customer relations and service recovery. It is advised patients obtain the *** code(s) for ordered services from the ordering providers office and contact their insurance to verify benefits prior to service. 

  Thank you for allowing us the opportunity to respond to this complaint. 

  ************** SSM Health Patient Financial Services 

   

  Customer response

  07/01/2024

  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.

  Thanks for taking care of this, but this is the first time I have been advised for patients to obtain CPT codes to verify with your insurance prior to service. Also need to question your process on responding to this issue in MyChart, phone calls and email.Although I am surprised to be advised to obtain CPT codes, since they are typically not made available to patients, this is the response I have attempted to acquire for over eight months. The only response I received was my issue had been escalated and the bill was sent to a **** collector.

  Sincerely,
  
  ***************************

• Initial Complaint

  06/24/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  Nurse and doctors broke the ***** law and contacted emergency contact and updated patients status....who is mom. Client asked for them not to talk to mom...but they continued stating that they were risking their jobs. They then deleted clients mychart after he became frustrated and blocked them. SSM doctor A. T. ...and SSM nurse A. C. ...who works in a totally different office. Another nurse texted the client and stated that what ever doctor is reaching out to mom is a big problem.I spoke with management who stated that it was not her nurses but there are two named professionals in my texts that texted Mt from February 2024 until May 2024 updating me on my son's Health. It's a ***** violation.

  Business response

  06/25/2024

  The information provided is not enough to identify the patient. I need additional information to locate and research. 

  Who is the patient? Who is the client? Is the complaint entered by family or counsel? 

  When did this occur (date, location)?

  What are the names of the persons involved? 

  Thank you, *********************;

  Customer response

  07/16/2024

  The patient is for my son and his name is *************************** and he is the client.  I submitted this compliant on my behalf even though he knew what I was about to do.  This was a total HIPPA Violation.  I started receiving text in 12/2023 I submitted all documentation to SSM management in  05/2024.  The people involved were Dr. ************************* and RN ***********************.  How would I know about his medication and treatment.  I have the telephone number that I was receiving the text messages from. 

  Business response

  07/17/2024

  6/13/2024 - It was found that this does not involve SLUCare Family ************** or anyone from SSM SLUCare. The alleged text messages did not come from anyone in our office. Several attempts were made to call the number, but no one answered. The mother (*****************) apologized over the phone to the Provider and ********************* (Supervisor) that this has turned into a family matter and is no longer a complaint. With that being said, our provider and RN's names were used in the text messages to convince the mother that the son has Stage II cancer, which there is no documentation of this in the patient's chart, unless he has been seen at an outside facility. Therefore, due to these false allegations and falsely using *************************, PA (Provider) and *****'s names, the department has dismissed the patient effective 6/17/2024 from the Family Medicine department. 

• Initial Complaint

  06/24/2024

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  SSM Health ****************** sent over an account to ************* to my medical line of credit that I didn't ask them to send over to them. I have asked multiple times to request the money to be returned back to *************. I have also asked them to apply the correct two accounts to my ************* medical line of credit.The mistake that they made was $1719.31 (an account that was still pending with insurance).

  Business response

  07/02/2024

  This correspondence serves as SSM Health's response to Complaint # ********. 

  This request has been completed. The requested corrections have been made to the ************* line of credit. A separate correspondence is being sent to the patient with detailed information. 

  Thank you for allowing us the opportunity to respond to this complaint. 

  ************** SSM Health Patient Financial Services 

  Customer response

  07/02/2024

  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.
  
  Sincerely,
  
  *********************

• Initial Complaint

  06/21/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  On 3/22/2024, my daughter had an outpatient diagnostic procedure performed by the provider. The procedure was processed by *************** leaving a balance of $2000 across two invoices. I am making this complaint with my daughter, ********, who is presently out of the country without Internet access. She is a dependent on my family health care plan as she is a 22 year old, full time student. Her info:******************************* ***********************************. Louis, MO ***** Since the first SSMHealth invoice on 4/3, we have been working with an Aetna Health **************** to gain clarity on medical bill coding accuracy. This was concluded on 6/17.As a result of that conclusion, ******** is requesting financial assistance for (some) relief from the $2000 invoice as a full time student. We have called SSMHealth to advise that ******** is applying for Financial Assistance and have been advised that a decision will be rendered in ****** days. We have offered to make an initial payment on the balance due believing that she will need to minimally pay a portion of the bill. SSMHealth has a policy that if you agree to make even a partial payment (through a payment plan) that you cannot apply for Financial Assistance. It is one or the other. No exception can be made say multiple SSMHealth reps.The problem we face is one of time. SSMHealth advises that outstanding balances may go to Collections after the 4th billing notice which is scheduled for July 3rd.We have asked SSMHealth to stop that Collection process while we await a decision on Fin Assistance. Multiple reps tell us, "this cannot be done". We asked to expedite (complete in 30 days) the Fin Assistance review to learn of what relief, if any, will be provided to set up the payment plan. They said "no". Requests are only processed in order received.SSMHealth should provide an accommodation to ******** to file for Fin Assistance without the risk of her account going to Collections. Please press them to accommodate.

  Business response

  06/26/2024

  This correspondence serves as *** Health's response to Complaint # ********. 

  The complaint is regarding the *** Health Financial Assistance Policy and billing practices. *** Health Financial Assistance policy states application period begins on the first day the care is provided and ends on the 240th day after the patient is provided with the first post-discharge billing statement. 

  *** Health does not hold the billing while an application is processing. There is no policy that states a payment plan or partial payment negates the ability to apply for assistance.  A copy of the *** Health Financial Assistance Policy can be found at ***Health.com. 

  We encourage patients to set up a payment plan to keep an account in good standing during the application process. A separate communication will be sent to this patient outside of the BBB platform. 

  Thank you for allowing us the opportunity to respond to this complaint. 

  ************** *** Health Patient Financial Services

• Initial Complaint

  06/05/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  SSN ***** - St ****** said I had services done in 2/2023. They never billed me until 2/2024. When I called SSN they said yes it can take a year to finalizes with insurance company. I do not believe that. ( I really do not know if a service was provided. After a year I have no records.) I am paying $5.00 a month as I am a senior on social security. They have turned me into a collection agency saying the bill is over a year old. I just received the bill 2/2024. I want them to stop the calls from the collection agency and not have this effect my credit. They should give me a year to pay off the charges. After all it took SSN Health - St ****** a year to bill for services Again I do not know if any service took place! Every other bill i have had with SSN is paid with in their payment terms.

  Business response

  06/05/2024

  This correspondence serves as *** Health's response to Complaint # ********. 

  The complaint states *** Health ************************* sent a statement a year after the services were provided and sent the balance to outside collections. 

  Documentation in the chart supports the patient was seen and treated at the *** Health *********** which is billed through *************************. The charges are correct for the services provided. Insurance did take a year to process the claim. As a courtesy and due to the delay in billing statements in a timely manner, the remaining balance has been adjusted to $0.00, alleviating the patient of any further financial responsibility for this date of service. 

  Thank you for allowing us the opportunity to respond to this complaint. 

  ************** *** Health ***************** Services 

• Initial Complaint

  06/03/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Resolved

  More info

  On 11/28/23 I had a colonoscopy. I was billed $83 by SSM. On 1/17/24 I along with Aetna my insurance did a 3 way call with SSM to explain how to bill them for $83. I kept getting these bills. I called 1/17, 2/12, 3/11, 4/15, 5/6, 5/7, and twice on 6/3. Each time I explained how to bill for the $83. SSM now is threatening me with a collection agency. I was told on 5/7 SSM would put it in escalation and get it resolved. I have spent way too many hours dealing with this in the past 6 months. and its SSM fault. Today a girl named ****** with SSM I told my complaint to and then she said she cant help me because shes new. Not only have I spoke 8 times to people at SSM but twice I asked for a call back and was never called back. This borders on harassment, especially the monthly collection agency threats along with the tremendous amount of time *** spent trying to explain how easy it is to **************.

  Business response

  06/04/2024

  This correspondence serves as SSM Health's response to Complaint # ********. 

  The complaint states the patient called and provided the insurance information to be billed and after repeated attempts to resolve the issue his insurance was still not billed. 

  The balance on this account was adjusted for customer satisfaction. SSM ********************** had the correct information for billing and failed to follow through and **** the claim. 

  Thank you for allowing us the opportunity to respond to this complaint. 

  ************** SSM Health ***************** Services 

  Customer response

  06/06/2024

  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.
  
  Sincerely,
  
  ***************************

• Initial Complaint

  05/29/2024

  Complaint Type:

  Order Issues

  Status:

  Answered

  More info

  My routine lab work that we monitor yearly & used to pay 26 $ copay was CODED WRONG & they are billing me over 1000$. My insurance is willing to own up & pay 4 it, if they submit it right, but SSM is not willing to do so for some wierd reason?! I already told them that they should if they want their money. I`m not going to pay this since I have the enhanced insurance premium & will NOT get entangled in their bureaucracy, so they`ve been playing ping - pong with me between the insurance company - lab - dr. ****** ******* not getting anywhere :( Please help!

  Business response

  06/03/2024

  This correspondence serves as SSM Healths response to Complaint # ********.

  The complaint states the diagnosis coding on the labs is incorrect resulting in an outstanding balance that should process as annual wellness.

  SSM Health coding department completed a review of the coding. Coding is the conversion of health care diagnoses for services, procedures, and equipment into universal codes for billing to insurance. SSM Health follows CMS (Centers for ***************** Services) who set the billing guidelines for these services.Diagnosis codes are taken from the physicians orders and documentation in the medical record and cannot be revised without updates or addendums from the ordering physician. Coding is correct according to documentation in the medical record. These labs were ordered as the result of an office visit not associated with an annual wellness examination. Insurance processed the claim according to the members benefits and the balance remains the patients responsibility.

  Thank you for allowing us the opportunity to respond to this complaint.

  ************** SSM Health ***************** Services

• Initial Complaint

  05/28/2024

  Complaint Type:

  Product Issues

  Status:

  Answered

  More info

  I paid my bill with my credit card through SSM online portal, My chart on my surgery day on 07/12/23. (*Please see the attached file for the confirmation) I thought this will be easier to pay before the surgery.Two months later, I got another bill for the same surgery, so I called to find out, then she was saying that my first transaction was failed, or something went wrong. If you look at my documents from my back account, showed it was taken out from my account. But I didn't know that then. Before I checked with my bank and my bad that I paid this time with same credit card again through My chart. I thought the customer service is telling me the truth. It had some deduction from a bill, which changed to lower total amount this time. But then I got my bank statement later, saw both were on them! Since then, I've been trying to explain to SSM that my 1st bill never got refunded, and that means I paid twice on the same surgery. No help from SSM billing department for next few months, so I went to my bank branch to obtain all my detailed transactions to send them to SSM. I also have been calling the hotline to request my refund multiple times, but almost no one knew about my July transaction was made through. It just shows my balance is zero! All I want SSM to refund me that $4K that disappear in July 2023. Please help me to resolve this issue. I have done everything I could to get my money back. I appreciate your help.

  Business response

  06/03/2024

  This correspondence serves as SSM Healths response to Complaint # ********.

  The complaint states the patient submitted two payments for the same service and attempts to secure a refund of the overpayment have been unsuccessful.

  The incorrect action was taken on this account and the payment was reversed, not refunded. This removes the payment without issuing a refund. The payment has been located, reposted to the account and a refund issued to our patient. A separate letter with details of this transaction is being sent to **************.

  Thank you for allowing us the opportunity to respond to this complaint.

  
  ************** SSM Health ***************** Services 

*Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business. ↩